Abstract
Supporting children with neurodevelopmental disabilities (NDDs) is recognized as an increasing priority in Fiji, a middle-income Pacific Island country. Our objective was to describe our approach to developing a model of care and strengthening local leadership in developmental paediatrics in Fiji to ensure high-quality identification, assessment and management of children with NDDs. Paediatric staff at Colonial War Memorial (CWM) Hospital in Suva have worked in partnership with Australian paediatricians to develop the model of care. The platform of continuing medical education during biannual 3 to 4 days of clinic-based teaching with visiting developmental paediatricians from Australia has been used. Since 2010, there have been 15 local and regional paediatric trainees trained. Since 2015, our two local lead paediatric trainees have run a weekly local developmental clinic. In total, 370 children aged 0 to 18 with NDDs have been comprehensively assessed with a detailed history and standardised tools. The model is extending to two divisional hospitals. Research engagement with the team is resulting in the development of a local evidence base. Local, regional and international leadership and collaboration has resulted in increased capacity in the Fijian health system to support children with NDDs.
Highlights
Worldwide, over the last 15 years, there have been marked improvements in the number of children surviving infancy and early childhood in low- and middle-income countries (LMICs), due to social and economic changes and advances in the provision of universal health care [1]
The World Bank has published seminal policy guidelines on the importance of a diagnostic work up of children with neurodevelopmental disabilities (NDDs) in order to inform intervention plans made with children and their families [13]. Translating these global policies and frameworks into action at national and subnational level through health services for children with NDDs is a challenge in Fiji as in other LMICs
We present a commentary to describe a ten-year collaborative effort between the Fijian Paediatric Clinical Services Network and developmental paediatric colleagues in Australia to develop a model of care for children with NDDs in Fiji
Summary
Over the last 15 years, there have been marked improvements in the number of children surviving infancy and early childhood in low- and middle-income countries (LMICs), due to social and economic changes and advances in the provision of universal health care [1]. Development Goals (SDGs) launched in 2015 have a focus on improved health but health equity and optimal early childhood development, with SDG indicator 4.2.1 in particular relating to the percentage of children under 5 who are developmentally on track in health, learning and psychosocial wellbeing [2] Key to this global strategy is supporting children with neurodevelopmental disabilities (NDDs). The World Bank has published seminal policy guidelines on the importance of a diagnostic work up of children with NDDs in order to inform intervention plans made with children and their families [13] Translating these global policies and frameworks into action at national and subnational level through health services for children with NDDs is a challenge in Fiji as in other LMICs. there is a clear evidence base for supporting LMIC health systems through policy and workforce development to improve neonatal outcomes, and communicable diseases, the evidence for health systems supporting children with NDDs is in its infancy [10].
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